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When someone mentions habits, the first thing that usually comes to mind are the obvious ones — smoking, drinking, overeating, procrastinating — the behaviors we know probably are not good for us. But habits run much deeper than those examples. In many ways, they form the invisible architecture of our entire lives.
Within my framework, human behavior is shaped by an ongoing tension between two internal systems: the Automatic Brain (AB) and the Mind. The AB almost always has the upper hand. Its fight-or-flight mechanism is powerful, physiologically compelling, and deeply rooted in our evolutionary past. Its job is simple: detect danger, threat, or vulnerability and react quickly enough to keep us alive.
The Mind operates very differently. Its influence is quieter, reflective, and deliberate. It evaluates rather than reacts. Unfortunately, most of us go through large portions of our lives without recognizing that this voice is even present. Much of my writing is devoted to helping people become aware of that distinction.
One of the AB’s defining characteristics is its reaction to uncertainty. Anything unfamiliar, unexpected, or outside of routine is interpreted as potential danger. When that happens, the AB nudges us back toward what feels familiar and predictable. Over time those routines become habits, habits establish what feels normal, and eventually that sense of normal becomes what we expect from life — whether it is beneficial to us or not.
When Pain Becomes the Habit
Last summer I began experiencing persistent discomfort in my elbow and shoulder. As both a physician and an athlete, I had a reasonable sense of what might be happening, and an evaluation confirmed it. I had developed golfer’s elbow, an irritation of the tendons on the inside of the elbow, along with a pectoralis major tendinopathy affecting the tendon connecting the chest muscle to the arm. Neither condition was particularly serious on its own, but together they became frustrating.
At the time, I had just become proficient at movements that once seemed completely out of reach for me — kipping pull-ups, rope climbs, and other demanding gymnastic movements. I felt capable and encouraged by the progress. Then something subtle began to happen. I started to feel insecure about movements that had previously felt natural. Every small twinge made me question whether I was pushing too hard or doing something wrong.
Eventually, I reached a point where I was ready to scale everything back significantly. Looking back, that reaction was the AB at work — not protecting me so much as confining me. The discomfort had become so expected that my nervous system began to interpret exertion itself as something to be avoided.
What is interesting — and something we see frequently in medicine — is that this reaction can actually interfere with healing. When the AB perceives threat or insecurity, the body subtly shifts into a protective state. Muscles tighten, movement becomes guarded, and blood flow can be reduced in the very areas that need circulation for recovery. In other words, the fear and insecurity surrounding an injury can sometimes make the healing process more difficult than the injury itself.
After a conversation with my coach, I made a different decision. I modified my workouts so I could continue moving without aggravating the injury, but I did not back away from training altogether. Over time, something interesting happened. Movement gradually felt normal again, and with that shift came renewed confidence and steady progress.
When the Body Learns the Wrong Normal
Illness can unfold in a similar way. When symptoms persist — fatigue, pain, digestive disturbances, dizziness — the AB begins cataloging those sensations as the new baseline. The body becomes accustomed to the signals, and the nervous system begins to expect them. What began as a temporary disruption can slowly become the pattern that defines daily experience.
This is not weakness. It is simply the way our biology works. As physicians, we see this repeatedly: the nervous system learns through repetition and expectation. However, that same biological mechanism also means that the pattern is not necessarily permanent.
Turning the System in Your Favor
What the AB does not recognize is that the same process that reinforces negative patterns can also work in our favor. Positive habits — consistent exercise, restorative sleep, thoughtful nutrition, meaningful connection with others — gradually retrain the nervous system. Each repetition reinforces a new expectation and quietly communicates that these behaviors are normal and safe.
The Mind does not overpower the AB. Instead, it influences the direction in which those patterns develop. Through deliberate choices made consistently over time, the unfamiliar becomes familiar, and the uncomfortable becomes manageable.
A Simple Framework
If you feel stuck in a pattern — whether physical, emotional, or behavioral — it can help to approach the situation in three simple steps.
First, notice the expectation. What is the AB predicting in that situation? Pain, failure, embarrassment, rejection? Simply naming that expectation often loosens its grip.
Second, question whether the prediction is based on current reality or simply a pattern the AB learned earlier and never updated.
Third, take a small step directed by the Mind. Not a dramatic transformation, but a modest adjustment that allows forward movement. Sometimes the most helpful strategy is not to retreat entirely, but simply to modify and continue.
A New Normal
The goal is not to eliminate the AB. It will always be there, scanning for potential threats and attempting to protect us. The goal is simply to allow the Mind to participate more actively in the process, reminding us that what feels expected is not always what is true.
Habits are not destiny. They are simply what the nervous system has practiced most often.
And the encouraging news is that practice can change. When it does, what once felt difficult or even impossible can gradually become the new normal.
In many ways, this realization sits at the heart of the message I try to share: much of what we experience as fear, limitation, or self-doubt is often the AB reacting to patterns it learned long ago. Once we recognize that, we can begin to listen more carefully to the quieter voice of the Mind — and that is often where real change begins.